Compositions and methods for multipurpose disinfection and sterilization solutions

ABSTRACT

The present disclosure discloses compositions and methods for multipurpose disinfection and sterilization solutions broadly effective against multiple microbial pathogens. The present disclosure demonstrates broad spectrum antimicrobial activity against environmental and pathogenic amoeba, bacterial spores, vegetative bacteria, fungi, rickettsia, viruses, parasites and toxic microbial products. The multipurpose disinfection solutions of the present disclosure may be used alone or in combination for a variety of purposes, including disinfection of medical devices such as contact lenses, contact lens cases, surgical instruments, and dental instruments.

CROSS REFERENCE

This application is a division of U.S. application Ser. No. 15/256,299filed Sep. 2, 2016, which claims the benefit of U.S. ProvisionalApplication No. 62/213,964 filed Sep. 3, 2015, each of which thecontents are hereby incorporated by reference in their entirety.

BACKGROUND

The United States Centers for Disease Control and Prevention havereported that the annual direct hospital costs of treatinghealthcare-associated infections in the United States range from $35.7Bto $45B. The most frequent nosocomial infections are surgical siteinfections, hepatitis B virus infections, septicemia, gastroenteritis,hepatitis C virus infections, urinary tract infections, and meningitis.Microbial agents responsible for these infections include Acinetobacter,Burkholderia cepacia, Clostridium difficile, Clostridium sordellii,Enterobacteriaceae, hepatitis B virus, hepatitis C virus, humanimmunodeficiency virus, influenza viruses, Klebsiella, Staphylococcusaureus Mycobacterium abscessus, norovirus, Pseudomonas aeruginosa,Staphylococcus aureus, Mycobacterium tuberculosis,vancomycin-intermediate Staphylococcus aureus, vancomycin-resistantStaphylococcus aureus, and vancomycin-resistant Enterococci.

While certain novel features of this disclosure shown and describedbelow are pointed out in the claims, the disclosure is not intended tobe limited to the details specified, since a person of ordinary skill inthe relevant art will understand that various omissions, modifications,substitutions and changes in the forms and details of the disclosureillustrated and in its operation may be made without departing in anyway from the spirit of the present disclosure. No feature of thedisclosure is critical or essential unless it is expressly stated asbeing “critical” or “essential.”

BRIEF SUMMARY OF THE INVENTION

The present disclosure provides novel chemical formulations andcompositions for multiple uses including but not limited to disinfectionof contact lenses, contact cases, medical devices, othermedical/paramedical devices, and dental instruments.

Disclosed herein are methods of disinfection and sterilization utilizingthe presently-disclosed compositions broadly effective against multiplemicrobial pathogens.

Disclosed herein is a medical disinfecting composition comprising (a) achlorite salt; (b) a quaternary ammonium salt; (c) ammonium chloride;and (d) water. In some embodiments of a medical disinfectingcomposition, the chlorite salt is an alkali metal chlorite salt. In someembodiments, the alkali metal chlorite salt is sodium chlorite. In someembodiments of a medical disinfecting composition, the sodium chloriteis present in an amount ranging from about 0.0001% to about 0.1% (w/w).In some embodiments of a medical disinfecting composition, the sodiumchlorite is provided as a stabilized chlorine dioxide solution. In someembodiments of a medical disinfecting composition, the stabilizedchlorine dioxide is present in an amount ranging from about 0.005% toabout 1.0% (w/w). In some embodiments of a medical disinfectingcomposition, the stabilized chlorine dioxide solution comprises chlorinedioxide. In some embodiments of a medical disinfecting composition, thequaternary ammonium salt comprises C12 or C14 alkyl chain. In someembodiments, the quaternary ammonium salt is not benzalkonium chloride.In some embodiments of a medical disinfecting composition, thequaternary ammonium salt is C12-C14-alkyl(ethylbenzyl)dimethylammoniumchloride. In some embodiments of a medical disinfecting composition, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.00005% to about 0.1% (w/w). In someembodiments of a medical disinfecting composition, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.001% to about 0.1% (w/w). In someembodiments of a medical disinfecting composition, the ammonium chlorideis present in an amount ranging from about 0.001% to about 2.0% (w/w).In some embodiments of a medical disinfecting composition, thecomposition further comprises a buffer to maintain the pH between about7 and about 8. In some embodiments of a medical disinfectingcomposition, the pH is about 7.

Also disclosed herein is a method of disinfecting a medical devicecomprising contacting the medical device with a medical disinfectingcomposition comprising: (a) a chlorite salt; (b) a quaternary ammoniumsalt; (c) ammonium chloride; and (d) water. In some embodiments of amethod of disinfecting a medical device, the chlorite salt is an alkalimetal chlorite salt.

In some embodiments of a method of disinfecting a medical device, thealkali metal chlorite salt is sodium chlorite. In some embodiments of amethod of disinfecting a medical device, the sodium chlorite is presentin an amount ranging from about 0.0001% to about 0.1% (w/w). In someembodiments of a method of disinfecting a medical device, the sodiumchlorite is provided as a stabilized chlorine dioxide solution. In someembodiments of a method of disinfecting a medical device, the stabilizedchlorine dioxide is present in an amount ranging from about 0.005% toabout 1.0% (w/w). In some embodiments of a method of disinfecting amedical device, the stabilized chlorine dioxide solution compriseschlorine dioxide.

In some embodiments of a method of disinfecting a medical device, thequaternary ammonium salt is not benzalkonium chloride. In someembodiments of a method of disinfecting a medical device, the quaternaryammonium salt is C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride. Insome embodiments of a method of disinfecting a medical device, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.00005% to about 0.1% (w/w). In someembodiments of a method of disinfecting a medical device, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.001% to about 0.1% (w/w). In someembodiments of a method of disinfecting a medical device, the ammoniumchloride is present in an amount ranging from about 0.001% to about 2.0%(w/w). In some embodiments of a method of disinfecting a medical device,the method further comprises a buffer to maintain the pH between about 7and about 8.

In some embodiments of a method of disinfecting a medical device, themedical device is in contact with a mammal tissue after contacting themedical device with a medical disinfecting composition. In someembodiments of a method of disinfecting a medical device, the medicaldevice is selected from the group consisting of contact lenses, contactlens cases, surgical instruments, and dental instruments.

Other objects and advantages of this disclosure will become readilyapparent from the ensuing description.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings form part of the present specification and areincluded to further demonstrate certain aspects of the presentdisclosure. The disclosure may be better understood by reference to oneor more of these drawings in combination with the description ofspecific embodiments presented herein.

FIG. 1 shows formulations of two multipurpose disinfection solutions(SOL01 and SOL02).

FIG. 2 shows cytotoxicity rankings of the two presently-disclosedmultipurpose disinfection solutions (SOL01 and SOL02) and threecommercially available multipurpose disinfection solutions: BioTrue(SOL05)<Opti-Free (SOL03)<ReNu (SOL04)<SOL01<SOL02.

FIG. 3 shows the antimicrobial activity of the two presently-disclosedmultipurpose disinfection solutions (SOL01 and SOL02) and threecommercially available multipurpose disinfection solutions.

FIG. 4 shows the cytotoxic activity of the two presently-disclosedmultipurpose disinfection solutions (SOL01 and SOL02).

FIG. 5 shows a comparison of the two presently-disclosed multipurposedisinfection solutions (SOL01 and SOL02) and three commerciallyavailable multipurpose disinfection solutions (BioTrue (SOL05),Opti-Free (SOL03), and ReNu (SOL04)).

FIG. 6 shows the results of one hour of contact time with the twopresently-disclosed multipurpose disinfection solutions (SOL01 andSOL02) and three commercially available multipurpose disinfectionsolutions (BioTrue (SOL05), Opti-Free (SOL03), and ReNu (SOL04)) for P.aeruginosa (ATCC 9027).

FIG. 7 shows the results of one hour of contact time with the twopresently-disclosed multipurpose disinfection solutions (SOL01 andSOL02) and three commercially available multipurpose disinfectionsolutions (BioTrue (SOL05), Opti-Free (SOL03), and ReNu (SOL04)) for S.aureus (ATCC 6538).

FIG. 8 shows the results of two hours of contact time with the twopresently-disclosed multipurpose disinfection solutions (SOL01 andSOL02) and two commercially available multipurpose disinfectionsolutions (BioTrue (SOL05), Opti-Free (SOL03), and ReNu (SOL04)) for P.aeruginosa (ATCC 9027).

FIG. 9 shows the results of four hours of contact time the twopresently-disclosed multipurpose disinfection solutions (SOL01 andSOL02) and three commercially available multipurpose disinfectionsolutions (BioTrue (SOL05), Opti-Free (SOL03), and ReNu (SOL04)) for P.aeruginosa (ATCC 9027).

FIG. 10 shows the results of four hours of contact time with the twopresently-disclosed multipurpose disinfection solutions (SOL01 andSOL02) and three commercially available multipurpose disinfectionsolutions (BioTrue (SOL05), Opti-Free (SOL03), and ReNu (SOL04)) for S.aureus (ATCC 6538).

FIG. 11 shows the results of one hour and four hours of contact timewith two presently-disclosed multipurpose disinfection solutions (SOL01and SOL02) and three commercially available multipurpose disinfectionsolutions (BioTrue (SOL05), Opti-Free (SOL03), and ReNu (SOL04)) for S.marcescens.

FIG. 12 shows the results of one hour and four hours of contact timewith two presently-disclosed multipurpose disinfection solutions (SOL01and SOL02) and three commercially available multipurpose disinfectionsolutions (BioTrue (SOL05), Opti-Free (SOL03), and ReNu (SOL04)) for C.albicans.

FIG. 13 shows the results of one hour and four hours of contact timewith two presently-disclosed multipurpose disinfection solutions (SOL01and SOL02) and three commercially available multipurpose disinfectionsolutions (BioTrue (SOL05), Opti-Free (SOL03), and ReNu (SOL04)) for F.solani.

FIG. 14A shows the results of 96 h incubation of STR-325 and twocommercially available multipurpose disinfection solution (ReNu andBiotrue) for A. castellanii.

FIG. 14B shows the results of 1 h incubation of STR-325 and twocommercially available multipurpose disinfection solution (ReNu andBiotrue) for A. castellanii.

DETAILED DESCRIPTION

The recent use of Bacillus anthracis as a bioterrorism agent hasdemonstrated the need for a solution that can effectively inactivateanthrax spores and that does not damage the surfaces to which it isapplied, such as offices, computers, and surrounding equipment. Inresponse to recent anthrax contamination scares, the U.S. EnvironmentalProtection Agency has tested and recommended various disinfectionproducts for use in emergency cleanup, including chlorine dioxide(ClO₂). ClO₂ was found to be effective only on hard surfaces at aconcentration of 500 mg per liter with a 30-minute contact period. ClO₂blends have an approximate pH of 4 and may cause extensive damage towalls, computers, and other equipment to which they are applied.

Environmental hygiene beyond bioterrorism response is an area of growingconcern. Exposure to biocontaminants, including certain molds, can leadto illnesses. Significant effort is required to achieve the necessarylevel of decontamination in the remediation of buildings, schools, andresidences that are contaminated with mold.

Compositions that provide disinfection without damage to surfaces ortissue are necessary for proper cleaning and maintenance of contactlenses. There are over 40 million contact lens wearers in the UnitedStates, with more than 100 million estimated wearers worldwide. Regularuse of contact lenses without proper hygienic maintenance may lead tomultiple pathologies of the eye, including microbial keratitis. Morethan 80,000 eye infections occur per year in the US alone, with over 80%occurring in contact lens users. Approximately 1 in 600 contact lensusers experience an infection requiring some medical intervention eachyear. Current commercial multipurpose disinfection solutions (MPDS) aredeveloped for regular cleaning and antimicrobial disinfection tominimize the risks of potential adverse reactions associated withcontact lens wear; however, currently-used solutions do not adequatelydisinfect or sterilize contact lenses, as evidenced by eye infectionrates.

There are numerous other areas that may benefit from improved means ofdisinfection, including medical and paramedical device cleaning, dentalinstruments, medical appliances cleaning, high-level disinfectants andsterilants, and broad spectrum antimicrobial hygiene in the clinicalenvironment.

MPDS are the most widely used cleaners and disinfectants worldwide.These products are typically composed of a single solution fordisinfection and sterilization in various medical and environmentalsettings, yet this approach has proven to be infective. The majority ofcommercially-available MPDS currently use the same active ingredientdisinfectant, organic salts of biguanide-based antimicrobials, atequivalent concentrations in their formulations, making it easier forthese products to receive FDA approval at low cost. However, thisprovides limited disinfection across the microbial spectrum andincreases the potential for unwanted microbial growth on surfaces.

Some MPDS contain an additional disinfecting agent, quaternary ammonium(Polyquad), at very low concentrations. Biguanides contain cationicactive sites that facilitate cellular lysis through bacteria cell wallinteraction, while the addition of an ammonium-based chemical increasesthe stress upon the diverse microbial constituents that a MPDS isrequired to kill and/or deactivate.

An optimized disinfecting solution would preferably have broad spectrumantimicrobial activity and relatively low cytotoxicity. The compositionsand methods disclosed herein incorporate multiple chemical classmicrobial stressors to reduce microbial burden by direct killing and/ordeactivation. Different ingredients are utilized for different groups ofinfective agents and pathogens, applying the concept of incorporatingmultiple stressors to achieve disinfection.

Detailed descriptions of one or more embodiments are provided herein. Itis to be understood, however, that the present disclosure may beembodied in various forms. Therefore, specific details disclosed hereinare not to be interpreted as limiting, but rather as a basis for theclaims and as a representative basis for teaching one skilled in the artto employ the present disclosure in any appropriate manner.

Wherever the phrase “for example,” “such as,” “including” and the likeare used herein, the phrase “and without limitation” is understood tofollow unless explicitly stated otherwise. Similarly “an example,”“exemplary” and the like are understood to be non-limiting.

The term “substantially” allows for deviations from the descriptor thatdon't negatively impact the intended purpose. Descriptive terms areunderstood to be modified by the term “substantially” even if the word“substantially” is not explicitly recited. Therefore, for example, thephrase “wherein the lever extends vertically” means “wherein the leverextends substantially vertically” so long as a precise verticalarrangement is not necessary for the lever to perform its function.

The terms “comprising” and “including” and “having” and “involving” (andsimilarly “comprises”, “includes,” “has,” and “involves”) and the likeare used interchangeably and have the same meaning. Specifically, eachof the terms is defined consistent with the common United States patentlaw definition of “comprising” and is therefore interpreted to be anopen term meaning “at least the following,” and is also interpreted notto exclude additional features, limitations, aspects, etc. Thus, forexample, “a process involving steps a, b, and c” means that the processincludes at least steps a, b, and c. Wherever the terms “a” or “an” areused, “one or more” is understood, unless such interpretation isnonsensical in context.

Some embodiments of the MPDS disclosed herein contain either three orfour active disinfection components with disinfecting qualities anddistinct mechanisms of action for microbial killing and/or deactivation.To achieve significant disinfection, up to and including sterilization,numerous types of microorganisms, such as bacteria, spore formers,fungi/yeasts, protozoa, helminths/helminth eggs, and viruses, spanningmultiple Kingdoms are presumed to be encountered. Thus, a combination ofchemicals selected for disinfection must possess multiple mechanisms ofdisinfection in order to completely disinfect and sterilize all possiblecomponents of contamination.

As used herein “stabilized chlorine dioxide” or “SCD” refers to anaqueous sodium chlorite (NaClO₂) solution. In some embodiments,stabilized chlorine dioxide is prepared by buffering sodium chloritewith a carbonate or a phosphate, and hydrogen peroxide. In addition tosodium chlorite, stabilized chlorine dioxide may further comprise sodiumchlorate (NaClO₃) and sodium chloride (NaCl). In some embodiments andunder the right pH condition stabilized chlorine dioxide may furthercomprise chlorine dioxide (ClO₂). In some embodiments, the compositiondescribed herein comprises stabilized chlorine dioxide as a source ofsodium chlorite. In some embodiments, the stabilized chlorine dioxide ispresent in an amount ranging from about 0.005% to about 1.0% (w/w). Insome embodiments, sodium chlorite is present in the composition in anamount ranging from about 0.0001% to about 0.1% (w/w). In someembodiments, the oxychlorine-based component of the compositiondescribed herein (e.g. sodium chlorite, stabilized chlorine dioxide, orchlorine dioxide) inhibits the cellular protein synthesis. In someembodiments, the oxychlorine-based component of the compositiondescribed herein (e.g. sodium chlorite, stabilized chlorine dioxide, orchlorine dioxide) inhibits the destruction of disulfide bonds.

As used herein “quaternary ammonium cations” also known as quats, referto positively charged polyatomic ions of the structure NR₄ ⁺, R being analkyl group or an aryl group. Unlike the ammonium ion (NH₄ ⁺) and theprimary, secondary, or tertiary ammonium cations, the quaternaryammonium cations are permanently charged, independent of the pH of theirsolution. Quaternary ammonium salts or quaternary ammonium compounds aresalts of quaternary ammonium cations. In some embodiments, thecomposition described herein comprises a quaternary ammonium salt. Insome embodiments, the quaternary ammonium salt comprises a C12 or C14alkyl chain. In some embodiments, the quaternary ammonium salt is notbenzalkonium chloride. In some embodiments, the quaternary ammonium saltis C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride. In someembodiments, the quaternary ammonium salt, e.g.,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in thecomposition in an amount ranging from about 0.00005% to about 0.1%(w/w), from about 0.001% to about 0.1% (w/w), or from about 0.001% toabout 0.05% (w/w). In some embodiments, the quaternary ammonium saltdestroys phospholipids within microbial cell wall, prompting autolysis,and microbial cell entry for the oxychlorine-based component in theformulation (e.g. sodium chlorite, stabilized chlorine dioxide, orchlorine dioxide).

As used herein “ammonium chloride” refers to NH₄Cl. In some embodiments,the composition described herein comprises ammonium chloride. In someembodiments, the ammonium chloride is present in the composition in anamount ranging from about 0.001% to about 2.0% (w/w). In someembodiments, ammonium chloride enhances the effectiveness for autolysison hard-to-kill Gm-bacteria and spore formers, fungi, and recalcitrantorganism such as pathogenic amoeba.

Compositions

Disclosed herein is a medical disinfecting composition comprising (a) achlorite salt; (b) a quaternary ammonium salt; (c) ammonium chloride;and (d) water. In some embodiments, the water is deionized water. Insome embodiments of a medical disinfecting composition, the chloritesalt is an alkali metal chlorite salt. In some embodiments of a medicaldisinfecting composition, the alkali metal chlorite salt is sodiumchlorite. In some embodiments of a medical disinfecting composition, thesodium chlorite is present in an amount ranging from about 0.0001% toabout 0.1% (w/w). In some embodiments of a medical disinfectingcomposition, sodium chlorite is present in the composition in an amountof about 0.0001%, about 0.0002%, about 0.0003%, about 0.0005%, about0.0006%, about 0.0007%, about 0.0008%, about 0.0009%, about 0.001%,about 0.002%, about 0.003%, about 0.004%, about 0.005%, about 0.006%,about 0.007%, about 0.008%, about 0.009%, about 0.01%, about 0.02%,about 0.03%, about 0.04%, about 0.05%, about 0.06%, about 0.07%, about0.08%, about 0.09%, or about 0.1% (w/w). In some embodiments of amedical disinfecting composition, the sodium chlorite is provided as astabilized chlorine dioxide solution. In some embodiments of a medicaldisinfecting composition, the stabilized chlorine dioxide is present inan amount ranging from about 0.005% to about 1.0% (w/w). In someembodiments of a medical disinfecting composition, the stabilizedchlorine dioxide is present in an amount of about 0.01%, about 0.02%,about 0.03%, about 0.04%, about 0.05%, about 0.06%, about 0.07%, about0.08%, about 0.09%, about 0.10%, about 0.11%, about 0.12%, about 0.13%,about 0.14%, about 0.15%, about 0.16%, about 0.17%, about 0.18%, about0.19%, about 0.2%, about 0.21%, about 0.22%, about 0.23%, about 0.24%,about 0.25%, about 0.30%, about 0.35%, about 0.40%, about 0.45%, about0.50%, about 0.55%, about 0.60%, about 0.65%, about 0.70%, about 0.75%,about 0.80%, about 0.85%, about 0.90%, about 0.95%, or about 1.0% (w/w).In some embodiments of a medical disinfecting composition, thestabilized chlorine dioxide solution comprises chlorine dioxide. In someembodiments of a medical disinfecting composition, the quaternaryammonium salt comprises C12 or C14 alkyl chain. In some embodiments of amedical disinfecting composition, the quaternary ammonium salt is notbenzalkonium chloride. In some embodiments of a medical disinfectingcomposition, the quaternary ammonium salt isC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride. In some embodimentsof a medical disinfecting composition, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.00005% to about 0.1% (w/w). In someembodiments of a medical disinfecting composition, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.001% to about 0.1% (w/w). In someembodiments of a medical disinfecting composition, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in thecomposition in an amount ranging from about 0.001% to about 0.1% (w/w),from about 0.001% to about 0.01% (w/w), or from about 0.001% to about0.05% (w/w). In some embodiments of a medical disinfecting composition,the C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in inthe composition in an amount of about 0.0001%, about 0.001%, about0.0015%, about 0.002%, about 0.0125%, about 0.025%, or about 0.05%. Insome embodiments of a medical disinfecting composition, the ammoniumchloride is present in an amount ranging from about 0.001% to about 2.0%(w/w). In some embodiments of a medical disinfecting composition, theammonium chloride is present in the composition in an amount of about0.001%, about 0.002%, about 0.003%, about 0.004%, about 0.005%, about0.006%, about 0.007%, about 0.008%, about 0.009%, about 0.01%, about0.02%, about 0.03%, about 0.04%, about 0.05%, about 0.06%, about 0.07%,about 0.08%, about 0.09%, about 0.10%, about 0.11%, about 0.12%, about0.13%, about 0.14%, about 0.15%, about 0.16%, about 0.17%, about 0.18%,about 0.19%, about 0.2%, about 0.21%, about 0.22%, about 0.23%, about0.24%, or about 0.25% (w/w). In some embodiments of a medicaldisinfecting composition, the composition further comprises a buffer tomaintain the pH between about 7 and about 8. In some embodiments of amedical disinfecting composition, the pH is about 7. In some embodimentsof a medical disinfecting composition, the buffer is a borate buffer. Insome embodiments of a medical disinfecting composition, the buffer is aphosphate buffer.

In some embodiments of a medical disinfecting composition, thecomposition further comprises tonicity agents. Non-limiting example oftonicity agents are sodium chloride and potassium chloride. In someembodiments of a medical disinfecting composition, the tonicity agent ispresent in the composition in an amount of less than about 1% (w/w), orless than about 0.9%, or less than about 0.8%, or less than about 0.7%,or less than about 0.5%.

In some embodiments of a medical disinfecting composition, thecomposition further comprises a non-ionic surfactant. In someembodiments of a medical disinfecting composition, the non-ionicsurfactant comprises a block copolymer. In some embodiments of a medicaldisinfecting composition, the block copolymer is Tetronic® 908. In someembodiments of a medical disinfecting composition, the non-ionicsurfactant is present in the composition in an amount of less than about1%, less than about 0.95%, less than about 0.9%, less than about 0.85%,less than about 0.8%, less than about 0.75%, less than about 0.7%, lessthan about 0.65%, less than about 0.6%, less than about 0.55%, less thanabout 0.5%, less than about 0.45%, less than about 0.4%, less than about0.35%, less than about 0.3%, or less than about 0.25%.

Also disclosed herein is a medical disinfecting composition comprising(a) a predetermined concentration of chlorine dioxide; (b) apredetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride; (c) a predeterminedconcentration of ammonium chloride; and (d) an amount of deionized watersufficient to maintain the predetermined concentrations of chlorinedioxide, C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, andammonium chloride. In some embodiments, the medical disinfectingcomposition further comprises an amount of stabilized water sufficientto maintain the predetermined concentrations of chlorine dioxide,C12-C14-Alkyl(ethylbenzyl)dimethylammonium chloride, and ammoniumchloride. In some embodiments, the predetermined concentration ofchlorine dioxide is between about 0.005% and about 1.0%. In someembodiments, the chlorine dioxide is provided as stabilized chlorinedioxide. In some embodiments, the predetermined concentration ofC12-C14-Alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1%.

In some embodiments, the predetermined concentration of ammoniumchloride is between about 0.001% and about 2.0%. In some embodiments,the stabilized water is not corrosive or scaling. In some embodiments,the pH of the medical disinfecting composition is greater than or equalto about 8.0.

Also disclosed herein is a medical disinfecting composition comprising(a) a predetermined concentration of chlorine dioxide; (b) apredetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride; (c) a predeterminedconcentration of sodium nitrite; and (d) an amount of deionized watersufficient to maintain the predetermined concentrations of chlorinedioxide, C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and sodiumnitrite. In some embodiments, the medical disinfecting compositionfurther comprises an amount of stabilized water sufficient to maintainthe predetermined concentrations of chlorine dioxide,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and sodium nitrite.In some embodiments, the predetermined concentration of chlorine dioxideis between about 0.005% and about 1.0%. In some embodiments, thechlorine dioxide is provided as stabilized chlorine dioxide. In someembodiments, the predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1%. In some embodiments, the predeterminedconcentration of sodium nitrite is between about 0.001% and about 2.0%.In some embodiments, the stabilized water is not corrosive or scaling.In some embodiments, the pH of the medical disinfecting composition isless than or equal to about 6.5.

Also disclosed herein is a medical disinfecting composition comprising(a) a predetermined concentration of peracetic acid (b) a predeterminedconcentration of C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride;(c) a predetermined concentration of ammonium chloride; and (d) anamount of deionized water sufficient to maintain the predeterminedconcentrations of peracetic acid,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and ammoniumchloride. In some embodiments, the medical disinfecting compositionfurther comprises an amount of stabilized water sufficient to maintainthe predetermined concentrations of peracetic acid,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and ammoniumchloride. In some embodiments, the predetermined concentration ofperacetic acid is between about 0.005% and about 1.0%. In someembodiments, the predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1%. In some embodiments, the predeterminedconcentration of ammonium chloride is between about 0.001% and about2.0%. In some embodiments, the stabilized water is not corrosive orscaling. In some embodiments, the pH of the medical disinfectingcomposition is greater than or equal to about 8.0.

Also disclosed herein is a medical disinfecting composition comprising(a) a predetermined concentration of peracetic acid; (b) a predeterminedconcentration of C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride;(c) a predetermined concentration of sodium nitrite; and (d) an amountof deionized water sufficient to maintain the predeterminedconcentrations of peracetic acid,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and sodium nitrite.In some embodiments, the medical disinfecting composition furthercomprises an amount of stabilized water sufficient to maintain thepredetermined concentrations of peracetic acid,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and sodium nitrite.In some embodiments, the predetermined concentration of peracetic acidis between about 0.005% and about 1.0%. In some embodiments, thepredetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1%.

In some embodiments, the predetermined concentration of sodium nitriteis between about 0.001% and about 2.0%. In some embodiments, thestabilized water is not corrosive or scaling. In some embodiments, thepH of the composition is less than or equal to about 6.5.

In some embodiments, the predetermined concentration of chlorine dioxidecomprises about 0.01%, the predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride comprises about0.002%, the predetermined concentration of ammonium chloride comprisesabout 0.1% to about 0.005%, and the chlorine dioxide is provided asstabilized chlorine dioxide. In some embodiments, the pH of thecomposition is between about 6.5 and about 11. In some embodiments, theoxidation-reduction potential (ORP) of the composition is between about−70 and about −90.

Also disclosed herein is a medical disinfecting composition comprising apredetermined concentration of chlorine dioxide; (a) a predeterminedconcentration of C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride;(b) a predetermined concentration of ammonium chloride; (c) apredetermined concentration of peracetic acid; and (d) an amount ofdeionized water sufficient to maintain the predetermined concentrationsof chlorine dioxide, C12-C14-alkyl(ethylbenzyl)dimethylammoniumchloride, ammonium chloride, and peracetic acid. In some embodiments,the composition further comprises an amount of stabilized watersufficient to maintain the predetermined concentrations of chlorinedioxide, C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, ammoniumchloride, and peracetic acid. In some embodiments, the predeterminedconcentration of chlorine dioxide is between about 0.005% and about0.05%. In some embodiments, the predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1%. In some embodiments, the predeterminedconcentration of ammonium chloride is between about 0.001% and about0.1%. In some embodiments, the predetermined concentration of peraceticacid is between about 0.00005% and about 0.05%. In some embodiments, thestabilized water is not corrosive or scaling. In some embodiments, thechlorine dioxide is stabilized. In some embodiments, the pH of thecomposition is between about 2.0 and about 6.0. In some embodiments, theoxidation-reduction potential (ORP) comprises between about 170 andabout 190. In some embodiments, the predetermined concentration ofchlorine dioxide comprises about 0.01%, the predetermined concentrationof C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride comprises about0.002%, the predetermined concentration of ammonium chloride comprisesabout 0.005%, the predetermined concentration of peracetic acidcomprises about 0.0005%, and the chlorine dioxide is provided asstabilized chlorine dioxide.

In one embodiment, provided herein is a medical disinfecting compositioncomprising chlorine dioxide (“SCD”);C12-C14-Alkyl(ethylbenzyl)dimethylammonium chloride (“ADC”); ammoniumchloride; and water. In an alternative embodiment, the aforementionedmedical disinfecting composition comprises deionized water.

In one embodiment, the amount of chlorine dioxide is about 0.01% (w/w),the amount of C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride isabout 0.002% (w/w), the amount of ammonium chloride is about 0.1% toabout 0.005% (w/w), and chlorine dioxide is provided as stabilizedchlorine dioxide. In some embodiments, the pH of the composition isbetween about 6.5 and about 11, and the oxidation-reduction potential(ORP) of the composition is between about −70 and about −90. In someembodiments, the amount of chlorine dioxide is between about 0.005% andabout 1.0% (w/w). In some embodiments, the chlorine dioxide is providedas stabilized chlorine dioxide. In some embodiments, the amount ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 1.0% (w/w). In some embodiments, the amount of ammoniumchloride is between about 0.001% and about 2.0% (w/w). The compositionof the solution controls the alkalinity, hardness, pH, temperature, andtotal dissolved solids at an equilibrium or stable state. In someembodiments, the pH of the composition is greater than or equal to about8.0. In some embodiments, the pH of the composition is greater than orequal to about 7.0. In some embodiments, the pH of the composition isabout 7.0.

In another embodiment, provided herein is a medical disinfectingcomposition comprising chlorine dioxide;C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride sodium nitrite; andwater. In an alternative embodiment, the aforementioned medicaldisinfecting composition comprises deionized water. In some embodiments,the amount of chlorine dioxide is between about 0.005% and about 1.0%(w/w). In some embodiments, chlorine dioxide is provided as stabilizedchlorine dioxide. In some embodiments, the amount ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1% (w/w). In some embodiments, the amount of sodiumnitrite is between about 0.001% and about 2.0% (w/w). In someembodiments, the pH of the medical disinfecting composition is less thanor equal to about 6.5.

In another embodiment, provide herein is medical disinfectingcomposition comprising peracetic acid;C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride; ammonium chloride;and water. In some embodiments, the amount of peracetic acid is betweenabout 0.005% and about 1.0% (w/w). In an alternative embodiment, theaforementioned medical disinfecting composition comprises deionizedwater. In some embodiments, the amount ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1% (w/w). In some embodiments, the amount of ammoniumchloride is between about 0.001% and about 2.0% (w/w). In someembodiments, the pH of the medical disinfecting composition is greaterthan or equal to about 8.0.

In another embodiment, provided herein is a medical disinfectingcomposition comprising peracetic acid;C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride sodium nitrite; andwater. In some embodiments, the amount of peracetic acid is betweenabout 0.005% and about 1.0% (w/w). In an alternative embodiment, theaforementioned medical disinfecting composition comprises deionizedwater. In some embodiments, the amount ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1% (w/w). In some embodiments, the amount of sodiumnitrite is between about 0.001% and about 2.0% (w/w). In someembodiments, the pH of the composition is less than or equal to about6.5.

In another embodiment, provided herein is a disinfecting compositioncomprising chlorine dioxide; C12-C14-alkyl(ethylbenzyl)dimethylammoniumchloride; ammonium chloride; peracetic acid; and water. In analternative embodiment, the aforementioned medical disinfectingcomposition comprises deionized water. In some embodiments, the amountof chlorine dioxide is between about 0.005% and about 0.05% (w/w). Insome embodiments, the amount ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1% (w/w). In some embodiments, the amount of ammoniumchloride is between about 0.001% and about 0.1% (w/w). In someembodiments, the amount of peracetic acid is between about 0.00005% andabout 0.05% (w/w). In some embodiments, chlorine dioxide is provided asstabilized chlorine dioxide. In some embodiments, the pH of the medicaldisinfecting composition is between about 2.0 and about 6.0, and theoxidation-reduction potential (ORP) is between about 170 and about 190.In some embodiments, the amount of chlorine dioxide is about 0.01%(w/w), the amount of C12-C14-alkyl(ethylbenzyl)dimethylammonium chlorideis about 0.002% (w/w), the amount of ammonium chloride is about 0.005%(w/w), the amount of peracetic acid is about 0.0005% (w/w), and chlorinedioxide is provided as stabilized chlorine dioxide. In otherembodiments, the amount of chlorine dioxide is about 0.10% (w/w), theamount of C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is about0.025% (w/w), the amount of peracetic acid is about 0.005% (w/w), theamount of ammonium chloride is about 0.05%, and chlorine dioxide isprovided as stabilized chlorine dioxide. In some embodiments, themedical disinfecting composition has a pH approximately equal to 4 andan oxidation-reduction potential (ORP) equal to about 180.

In another embodiments, provided herein is a medical disinfectingcomposition with a pH approximately equal to 8, an oxidation-reductionpotential (ORP) equal to about −81, and includes stabilized chlorinedioxide in an amount of about 0.10% (w/w),C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride in an amount ofabout 0.025% (w/w), and ammonium chloride in an amount of about 0.05%(w/w).

Disinfecting Methods

Also disclosed herein is a method of disinfecting a medical devicecomprising contacting the medical device with a medical disinfectingcomposition comprising: (a) a chlorite salt; (b) a quaternary ammoniumsalt; (c) ammonium chloride; and (d) water. In some embodiments of amethod of disinfecting a medical device, the chlorite salt is an alkalimetal chlorite salt. In some embodiments of a method of disinfecting amedical device, the alkali metal chlorite salt is sodium chlorite. Insome embodiments of a method of disinfecting a medical device, thesodium chlorite is present in an amount ranging from about 0.0001% toabout 0.1% (w/w). In some embodiments of a method of disinfecting amedical device, the sodium chlorite is present in the composition in anamount of about 0.0001%, about 0.0002%, about 0.0003%, about 0.0005%,about 0.0006%, about 0.0007%, about 0.0008%, about 0.0009%, about0.001%, about 0.002%, about 0.003%, about 0.004%, about 0.005%, about0.006%, about 0.007%, about 0.008%, about 0.009%, about 0.01%, about0.02%, about 0.03%, about 0.04%, about 0.05%, about 0.06%, about 0.07%,about 0.08%, about 0.09%, or about 0.1% (w/w). In some embodiments of amethod of disinfecting a medical device, the sodium chlorite is providedas a stabilized chlorine dioxide solution. In some embodiments of amethod of disinfecting a medical device, the stabilized chlorine dioxideis present in an amount ranging from about 0.005% to about 1.0% (w/w).In some embodiments of a method of disinfecting a medical device, thestabilized chlorine dioxide is present in an amount of about 0.01%,about 0.02%, about 0.03%, about 0.04%, about 0.05%, about 0.06%, about0.07%, about 0.08%, about 0.09%, about 0.10%, about 0.11%, about 0.12%,about 0.13%, about 0.14%, about 0.15%, about 0.16%, about 0.17%, about0.18%, about 0.19%, about 0.2%, about 0.21%, about 0.22%, about 0.23%,about 0.24%, about 0.25%, about 0.30%, about 0.35%, about 0.40%, about0.45%, about 0.50%, about 0.55%, about 0.60%, about 0.65%, about 0.70%,about 0.75%, about 0.80%, about 0.85%, about 0.90%, about 0.95%, orabout 1.0% (w/w). In some embodiments of a method of disinfecting amedical device, the stabilized chlorine dioxide solution compriseschlorine dioxide. In some embodiments of a method of disinfecting amedical device, the quaternary ammonium salt is not benzalkoniumchloride. In some embodiments of a method of disinfecting a medicaldevice, the quaternary ammonium salt isC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride. In some embodimentsof a method of disinfecting a medical device, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.00005% to about 0.1% (w/w). In someembodiments of a method of disinfecting a medical device, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.001% to about 0.1% (w/w). In someembodiments of a method of disinfecting a medical device, theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in thecomposition in an amount ranging from about 0.001% to about 0.1% (w/w),from about 0.001% to about 0.01% (w/w), or from about 0.001% to about0.05% (w/w). In some embodiments of a method of disinfecting a medicaldevice, the C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride ispresent in in the composition in an amount of about 0.0001%, about0.001%, about 0.0015%, about 0.002%, about 0.0125%, about 0.025%, orabout 0.05%. In some embodiments of a method of disinfecting a medicaldevice, the ammonium chloride is present in an amount ranging from about0.001% to about 2.0% (w/w). In some embodiments of a method ofdisinfecting a medical device, the ammonium chloride is present in thecomposition in an amount of about 0.001%, about 0.002%, about 0.003%,about 0.004%, about 0.005%, about 0.006%, about 0.007%, about 0.008%,about 0.009%, about 0.01%, about 0.02%, about 0.03%, about 0.04%, about0.05%, about 0.06%, about 0.07%, about 0.08%, about 0.09%, about 0.10%,about 0.11%, about 0.12%, about 0.13%, about 0.14%, about 0.15%, about0.16%, about 0.17%, about 0.18%, about 0.19%, about 0.2%, about 0.21%,about 0.22%, about 0.23%, about 0.24%, or about 0.25% (w/w). In someembodiments of a method of disinfecting a medical device, the methodfurther comprises a buffer to maintain the pH between about 7 and about8. In some embodiments of a method of disinfecting a medical device, thepH is about 7. In some embodiments of a method of disinfecting a medicaldevice, the medical device is in contact with a mammal tissue aftercontacting the medical device with a medical disinfecting composition.In some embodiments of a method of disinfecting a medical device, themammal tissue is a human tissue. In some embodiments of a method ofdisinfecting a medical device, the medical device is selected from thegroup consisting of contact lenses, contact lens cases, surgicalinstruments, and dental instruments. In some embodiments, the medicaldisinfecting composition described herein is not used for watertreatment purposes. In some embodiments, the medical disinfectingcomposition described herein is not used in pulp bleaching. In someembodiments, the medical disinfecting composition described herein isnot used on non-medical devices.

Also disclosed herein is a method of disinfecting an object comprising(a) providing an amount of a disinfecting composition; (b) applying theamount of the disinfecting composition to the object to be disinfected;and (c) allowing the amount of the disinfecting composition applied tothe object to contact the object for a predetermined amount of time.

In some embodiments, the disinfecting composition comprises (a) apredetermined concentration of chlorine dioxide; (b) a predeterminedconcentration of C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride;(c) a predetermined concentration of ammonium chloride; (d) an amount ofstabilized water sufficient to maintain the predetermined concentrationsof chlorine dioxide, C12-C14-alkyl(ethylbenzyl)dimethylammoniumchloride, and ammonium chloride; and (e) an amount of deionized watersufficient to maintain the predetermined concentrations of chlorinedioxide, C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, andammonium chloride. In some embodiments, the predetermined concentrationof chlorine dioxide is between about 0.005% and about 1.0%. In someembodiments, the chlorine dioxide is provided as stabilized chlorinedioxide. In some embodiments, the predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1%.

In some embodiments of the disinfecting method, the predeterminedconcentration of ammonium chloride is between about 0.001% and about2.0%. In some embodiments of the disinfecting method, the disinfectingcomposition comprises (a) a predetermined concentration of chlorinedioxide; (b) a predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride; (c) a predeterminedconcentration of sodium nitrite; (d) an amount of stabilized watersufficient to maintain the predetermined concentrations of chlorinedioxide, C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and sodiumnitrite; and (e) an amount of deionized water sufficient to maintain thepredetermined concentrations of chlorine dioxide,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and sodium nitrite.In some embodiments of the disinfecting method, the predeterminedconcentration of chlorine dioxide is between about 0.005% and about1.0%. In some embodiments, the chlorine dioxide is provided asstabilized chlorine dioxide. In some embodiments of the disinfectingmethod, the predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1%. In some embodiments of the disinfecting method,the predetermined concentration of sodium nitrite is between about0.001% and about 2.0%. In some embodiments of the disinfecting method,the disinfecting composition comprises (a) a predetermined concentrationof peracetic acid; (b) a predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride; (c) a predeterminedconcentration of ammonium chloride; (d) an amount of stabilized watersufficient to maintain the predetermined concentrations of peraceticacid, C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and ammoniumchloride; and (e) an amount of deionized water sufficient to maintainthe predetermined concentrations of peracetic acid,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, and ammoniumchloride. In some embodiments of the disinfecting method, thepredetermined concentration of peracetic acid is between about 0.005%and about 1.0%. In some embodiments of the disinfecting method, thepredetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1%. In some embodiments of the disinfecting method,the predetermined concentration of sodium nitrite is between about0.001% and about 2.0%. In some embodiments of the disinfecting method,the disinfecting composition comprises (a) predetermined concentrationof chlorine dioxide; (b) a predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride; (c) a predeterminedconcentration of ammonium chloride; (d) a predetermined concentration ofperacetic acid; (e) an amount of stabilized water sufficient to maintainthe predetermined concentrations of chlorine dioxide,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, ammonium chloride,and peracetic acid; and (f) an amount of deionized water sufficient tomaintain the predetermined concentrations of chlorine dioxide,C12-C14-alkyl(ethylbenzyl)dimethylammonium chloride, ammonium chloride,and peracetic acid. In some embodiments of the disinfecting method, thepredetermined concentration of chlorine dioxide is between about 0.005%and about 0.05%. In some embodiments, the predetermined concentration ofC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is between about0.001% and about 0.1%. In some embodiments, the predeterminedconcentration of ammonium chloride is between about 0.001% and about0.1%. In some embodiments of the disinfecting method, the predeterminedconcentration of peracetic acid is between about 0.00005% and about0.05%. In some embodiments, the predetermined amount of time is betweenabout two minutes and about four hours. In some embodiments of thedisinfecting method, the predetermined amount of time is between aboutone minute and one hour.

In some embodiments, the method of disinfecting further comprisesremoving the amount of the disinfecting composition applied to theobject from the object after the predetermined amount of time haspassed. In some embodiments, the amount of disinfecting composition isremoved from the object via one or more of the following methods:rinsing, drying, heat drying, wiping, sponging, blotting, rubbing,evaporation, or shaking. In some embodiments, the object is selectedfrom the group comprising contact lenses, contact lens cases, medicaldevices, paramedical devices, and dental instruments.

In another embodiment, provided herein is a method of disinfecting amedical device comprising providing an amount of a disinfectingcomposition; applying the amount of the disinfecting composition to themedical device to be disinfected; and allowing the amount of thedisinfecting composition applied to the medical device to contact themedical device for an amount of time. In some embodiments, thedisinfecting composition comprises any one or more of the disinfectingcomposition disclosed herein, alone or in combination, or comprises anysuitable disinfecting composition. In some embodiments, the amount oftime is between about two minutes and about four hours. In otherembodiments, the amount of time is between about one minute and onehour, or the amount of time is any amount of time that allows for asufficient reduction in microbial or infectious agents.

In some embodiments, the method further comprises removing the amount ofthe disinfecting composition applied to the medical device from themedical device after the amount of time has passed. In some embodiments,the disinfection composition is removed from the medical device via oneor more of the following methods: rinsing, drying, heat drying, wiping,sponging, blotting, rubbing, evaporation, shaking, or any other suitableremoval method. In some embodiments, the medical device is selected fromthe group comprising contact lenses, contact lens cases, surgicalinstruments, and dental instruments.

Formulations disclosed herein utilize different ingredients to target,kill, and/or inactivate different groups of infective agents orpathogens, applying concepts for multi-stressing disinfection agents.Oxidizing disinfectant agents inactivate gram positive bacteria,viruses, and fungi. Quaternary amines inactivate gram negative bacteria.Ammonia, nitrous acid, or other appropriate non-charged disinfectingagents, depending upon the pH, may be included to inactivate parasitesand protozoan oocysts. Surfactants enable the MPDS to be applied tovarious surfaces areas of a medical device.

EXPERIMENTAL SECTION Example 1: Comparison of SOL0! and SOL02 AgainstThree Commercially-Available MPDS

Standard methods for assessing the antimicrobial activity and thecytotoxicity of MPDS have been harmonized under International StandardsOrganization (ISO) standard laboratory procedures using a battery ofpreselected bacterial and fungal species. The standards for testingprovide a standardized comparison among multiple MPDS. The use ofstandard laboratory procedures for testing provides an opportunity forbenchmarking against a common battery of microbial challenge species.

Two presently-disclosed MPDS designated SOL01 (also referred to as“SL1”) and SOL02 (also referred to as “SL2”) were developed to bebroadly effective against multiple microbial pathogens by inclusion ofmultiple chemical stressors rather than a single disinfection agentwhile simultaneously exerting minimal cytotoxicity upon tissues uponcontact. The compositions of SOL01 and SOL02 are shown in the table ofFIG. 1. The cytotoxicity and antimicrobial activity of SOL01 and SOL02were compared against three commercially-available MPDS: ReNu fresh(active ingredient: Biguanide (0.0001%), Bausch & Lomb, Rochester,N.Y.), Opti-Free (active ingredients: Biguanide and Polyquad(polyquaternium; 0.001%), Alcon, Fort Worth, Tex.), and BioTrue (activeingredients: Biguanide (0.00013%), polyquaternium (0.0001%), andHyaluronan (hyaluronic acid), Bausch & Lomb).

Relative antimicrobial disinfection and cytotoxicity of SOL01 and SOL02and the three commercially-available MPDS were determined using ISOtesting protocols 14729 (antimicrobial) and 10993 (cytotoxicity). TheISO-required battery of microorganisms (S. aureus, P aeruginosa, S.marcesens, C. albicans, and F. solani) was used to assess thedisinfection potential of each MPDS with contact times of one hour andfour hours. Vero76 monkey kidney cells and XTT proliferation assay wereused to assess in vitro cytotoxicity of each MPDS.

The disinfection potential of SOL01 and SOL02 in the ISO-specificantimicrobial assay demonstrated no bacterial or fungal plate growth forany of the microorganisms tested with as little as one hour contacttime. All comparator MPDS, in contrast, showed significant growth at onehour contact times, with only slight reductions of bacterial or fungalgrowth after the four hours maximum contact time. Two of the threecomparator MPDS exceeded 90% cell death at about 25% solutionconcentration dilution but required about 12% solution concentrationdilution in order to minimize cytotoxicity from contact. SOL01 showedminimal cell death at approximately the same dilutions as comparatorsolutions, whereas SOL02 achieved similar performance with lowerconcentrations of about 1% to 3%.

The presently-disclosed MPDS (SOL01 and SOL02) combine broad spectrumantimicrobial killing against an array of microorganisms whilemaintaining minimal cytotoxicity on target tissues as demonstrated invitro. The performance of SOL01 in the two ISO-recommended standardassays exceeded the three commercially-available comparator MPDS inantimicrobial activity, yet maintained a similar cytotoxicity profile.Optimization of SOL01 and SOL02 for maintaining hygiene of contactlenses and contact lens cases may reduce toxic effects while stillmaintaining effective prevention of ocular infections from microbialcontamination.

Cytotoxicity

Cytotoxicity activity was evaluated in vitro based upon methodsdescribed in ISO standard 10993-5 (Biological Evaluation of MedicalDevices—Part 5: Tests for in vitro cytotoxicity). A colony-formationassay was conducted using African Green Monkey kidney cells (Vero76),one cell line recommended for use under this testing regime.Approximately 1.0E+06 Vero76 cells in 2 mL of medium (minimum essentialmedium+5% fetal calf serum: Life Technologies, CA, USA) were inoculatedinto 6-well culture plates (Life Technologies, CA, USA) and cultured forabout 48 hours at 37° C. at 5% CO₂ until adherent growth was confirmed.After washing and removal of the media, 1 mL of each SOL01, SOL02, andcommercial MPDS was diluted with deionized sterile water and then addedindividually into individual wells at serial dilutions up to 1:512.Physiological saline was used as a negative control. Plates wereincubated for about 48 hours at 37° C. at 5% CO₂ and then washed.Substrate was added and read at 490 nm. Proliferation was calculated intriplicate as (mean absorbance)×100/(mean absorbance/negative controlgroup). As shown in FIG. 2, FIG. 4 and FIG. 5, results were plotted, andthe relative cytotoxicity of each product compared.

All solutions were cytotoxic at full strength and showed aconcentration-dependent increase in cytotoxicity as solutionconcentration increased. SOL02 was not cytotoxic at low concentrationsof about 1% to about 3% but gradually increased to be highly cytotoxicat about 25%. ReNu, Opti-Free, and SOL01 were not cytotoxic atconcentrations between about 25% and about 12.5% but increased two-foldin toxicity at about 50% concentration. BioTrue was not cytotoxic atabout 50% solution concentration but was highly cytotoxic at fullstrength. Cytotoxicity rankings of the MPDS are as follows:BioTrue<Opti-Free≤ReNu≤SOL01<SOL02, as shown in FIG. 2.

Antimicrobial Activity

Antimicrobial activity was evaluated by using the methods described as a‘stand-alone’ contact lens disinfection test (ISO 14729, 2001), whichrequires that the MPDS product must be capable of reducing the viabilityof specified bacterial and fungal species by three logs (99.9%) and onelog (90%), respectively, within a particular timeframe. The standardbacterial and fungal organisms prescribed by the standard method arePseudomonas aeruginosa IFO13275 (also referred to as “Pa”),Staphylococcus aureus IFO13276 (also referred to as “Sa”), Serratiamarcescens ATCC13880 (also referred to as “Sm”), Candida albicansIFO1594 (also referred to as “Ca”) and Fusarium solani ATCC36031 (alsoreferred to as “Fs”). P. aeruginosa, S. aureus and S. marcescens wereobtained commercially (ATCC, Manassas, Va.) as lyophilized packs.Bacterial cultures were reconstituted in soya broth and incubated forabout 24 hours at 25° C. C. albicans and F. solani were obtainedcommercially (ATTC) and were grown in Sabouraud's dextrose in a similarfashion. All microorganisms were harvested using methods described inthe ISO 14729 standard and adjusted for concentration throughcentrifugation and dilution with PBS. Final challenge concentrations ofeach approximated 1.0E+06 to 1.0E+07 CFU/ml.

A known volume (100 μl) of the microbial suspension was added to 9.9 mLof each MPDS in a polypropylene tube under sterile conditions. Mixtureswere incubated at 25° C. for 1 hour, 2 hours, or 4 hours. After theprescribed contact time, the mixtures were sterile filtered through 0.45μm analytical filter funnels (140-4045, Fisher Scientific) and washedtwice with sterile DPBS. Each filter was aseptically removed from thefilter funnel, laid upon one of TSA (P. aeruginosa, S. aureus), SDA (S.marcescens) or PDA (C. albicans and F. solani), and incubated at 25° C.for growth. Colonies were counted after about 48 hours of incubation.Each assay was performed in duplicate.

Both SOL01 and SOL02 were completely sterilizing against all of themicroorganisms tested. As summarized in FIG. 3 and depicted in FIG.6-10, no growth on any of the plates at either the one hour or four hourcontact time point was observed. In contrast, none of the threecommercially available MPDS tested were effective in achieving any logreduction against P. aeruginosa (see FIG. 6, FIG. 8 and FIG. 9) or S.aureus (see FIG. 7 and FIG. 10) at either the one hour or four hourcontact time point. Two of the three commercial solutions (ReNu andBioTrue) showed some effectiveness against S. marcescens at one hour ofcontact time, with all three solutions achieving adequate microbialreduction at four hours of contact time (see FIG. 3 and FIG. 11). Onlyone of the three commercial solutions (BioTrue) was effective against C.albicans at one hour of contact time, with all three requiring fourhours of contact time to achieve some microbial reduction (see FIG. 3and FIG. 12). All three commercial solutions showed some effectivenessagainst F. solani at one hour and four hour contact times (see FIG. 3and FIG. 13). Two of the three commercial solutions (Opti-free andBioTrue) performed similarly to SOL01 and SOL02 at the four hour contacttime against F. solani, indicating no growth of the fungi (see FIG. 3and FIG. 12).

Both SOL01 and SOL02 were comprised primarily of stabilized chlorinedioxide. In addition to the chlorine-based disinfectant, a quaternaryammonium salt was included, which was shown to increase disinfectionqualities. Ammonium chloride was added to increase the availableammonium ions in conjunction with the quaternary ammonium salt.Peracetic acid was added to SOL02, which subsequently lowered the pH to5.5, possibly accounting for the increase in cytotoxicity in thisparticular formulation. The cytotoxicity testing for SOL01 indicated atoxicity profile within an acceptable range and highly comparable to thethree commercially-available MPDS. Addition of components toisotonically balance the solution in combination with appropriatebuffering and wetting agents may reduce the toxicity that was observedat concentrations over about 25%.

The combination of the three active ingredients in SOL01 resulted in acompletely sterilizing action against all of the challenge organismswith as little as one hour contact time. These results are in starkcontrast to the performance of the three commercially-available MPDS,which showed little ability to disinfect against standard microbialorganisms using contact times of either one hour or four hours.Performance of the commercial MPDS against the two strains of gramnegative bacteria (P. aeruginosa and S. Marcescens) and the one strainof gram positive bacteria (S. aureus) was unexpected, as log reductionsof these organisms have been achieved in past studies with the sameMPDS. Disinfection qualities of the commercial MPDS against the selectedfungi, C. albicans and F. solani, were more in line with expectationsbased upon previous work showing marginal or poor performance. Each ofSOL01 and SOL02 in contrast was completely sterilizing against both ofthe fungal organisms after only one hour of contact time.

The data shown here demonstrate that MPDS with multiplechemically-distinct active ingredients may be used as a disinfectant fora variety of applications. The MPDS disclosed herein surpass the currentstandard of care, represented by the commercially-available MPDS, interms of both disinfection capability and cytotoxicity. These resultsestablish that the multiple stressor approach disclosed herein is farsuperior for quick-acting disinfection across a broad spectrum ofmicroorganisms when compared to commercial counterparts.

Example 2: Exemplary BBS Based Formulation with Biocidal Test Results

A-2 B-2 C-2 D-2 E-2 F-2 Ingredient % (W/W) % (W/W) % (W/W) % (W/W) %(W/W) % (W/W) Boric Acid 0.850 0.850 0.850 0.850 0.850 0.850 SodiumBorate 0.130 0.130 0.130 0.130 0.130 0.130 Sodium Chloride 0.250 0.2500.250 0.250 0.250 0.250 Potassium Chloride 0.250 0.250 0.250 0.250 0.2500.250 Tetronic 908 0.250 0.250 0.250 0.250 0.250 0.250 Ammonium Chloride— — — 0.200 0.100 0.050 Stabilized Chlorine 0.04 0.02 0.01 — — — DioxidepH 7.39/7.44 7.39/7.44 7.39/7.44 7.39/7.44 7.39/7.44 7.39/7.44Osmolarity 290 290 290 290 290 290 Biocidal Test Results StaphylococcusNG NG NG Positive Positive Positive aureus Pseadomonas NG NG NG PositivePositive Positive aeruginosa Candida albicans NG NG Positive PositivePositive Positive Fusarium solani Positive Positive Positive PositivePositive Positive NG: no growth Positive: at least 1 colony forming unit(CFU) of growth.

Example 3: Exemplary Phosphate Buffer Based Formulation with BiocidalTest Results

A-3 B-3 C-3 D-3 E-3 F-3 Ingredient % (W/W) % (W/W) % (W/W) % (W/W) %(W/W) % (W/W) Sodium 0.165 0.165 0.165 0.165 0.165 0.165 Phosphate,Heptahydrate, Dibasic Sodium 0.050 0.050 0.050 0.050 0.050 0.050Phosphate, Monohydrate, monobasic Sodium 0.650 0.650 0.650 0.650 0.6500.650 Chloride Potassium 0.250 0.250 0.250 0.250 0.250 0.250 ChlorideTetronic 908 0.250 0.250 0.250 0.250 0.250 0.250 Ammonium — — — 0.2000.100 0.050 Chloride Stabilized 0.04 0.02 0.01 — — — Chlorine Dioxide pH7.0 7.0 7.0 7.0 7.0 7.0 Osmolarity 290 290 290 290 290 290 Biocidal TestResults Staphylococcus NG NG NG Positive Positive Positive aureusPseudomonas NG NG NG Positive Positive Positive aeruginosa Candida NG NGPositive Positive Positive Positive albicans Fusarium solani PositivePositive Positive Positive Positive Positive NG: no growth Positive: atleast 1 colony forming unit (CFU) of growth.

Example 4: Exemplary Phosphate Buffer Based Formulation with BiocidalTest Results

A-4 B-4 C-4 D-4 E-4 F-4 Ingredient % (W/W) % (W/W) % (W/W) % (W/W) %(W/W) % (W/W) Sodium Phosphate, 0.165 0.165 0.165 0.165 0.165 0.165Heptahydrate, Dibasic Sodium Phosphate, 0.050 0.050 0.050 0.050 0.0500.050 Monohydrate, monobasic Sodium Chloride 0.650 0.650 0.650 0.6500.650 0.650 Potassium Chloride 0.250 0.250 0.250 0.250 0.250 0.250Tetronic 908 0.250 0.250 0.250 0.250 0.250 0.250 Ammonium Chloride —0.200 0.200 — — — Stabilized Chlorine 0.01 0.01 — — — — Dioxide C12-C14-— — — 0.050 0.025 0.0125 alkyl(ethylbenzyl)dimethylammonium chloride(80%) pH 7.0 7.0 7.0 7.0 7.0 7.0 Osmolarity 290 290 290 290 290 290Biocidal Test Results Staphylococcus NG NG Positive NG NG NG aureusPseudomonas NG NG Positive NG NG NG aeruginosa Candida albicans PositiveNG Positive NG NG NG Fusarium solani Positive Positive Positive NG NG NGNG: no growth Positive: at least 1 colony forming unit (CFU) of growth.

Example 5: Exemplary Phosphate Buffer Based Formulation with BiocidalTest Results

A-5 % B-5 % C-5 % D-5 % E-5 % F-5 % G-5 % Ingredient (W/W) (W/W) (W/W)(W/W) (W/W) (W/W) (W/W) Sodium Phosphate, 0.165 0.165 0.165 0.165 0.1650.165 0.165 Heptahydrate, Dibasic Sodium Phosphate, 0.050 0.050 0.0500.050 0.050 0.050 0.050 Monohydrate, monobasic Sodium Chloride 0.6500.650 0.650 0.650 0.650 0.650 0.650 Potassium Chloride 0.250 0.250 0.2500.250 0.250 0.250 0.250 Tetronic 908 0.250 0.250 0.250 0.250 0.250 0.2500.250 Ammonium Chloride — — 0.20 — 0.20 0.20 0.20 Stabilized Chlorine —0.01 — 0.01 — 0.01 0.01 Dioxide C12-C14- 0.0125 — — 0.0125 0.0125 —0.125 alkyl(ethylbenzyl)dimethylammonium chloride (80%) pH 7.0 7.0 7.07.0 7.0 7.0 7.0 Osmolarity 290 290 290 290 290 290 290 Biocidal TestResults Staphylococcus NG NG Positive NG NG Positive NG aureusPseadomonas Positive Positive Positive NG NG NG NG aeruginosa Candidaalbicans NG Positive Positive NG NG Positive NG Fusarium solani NGPositive Positive NG NG Positive NG NG: no growth Positive: at least 1colony forming unit (CFU) of growth.

Example 6: Exemplary Phosphate Buffer Based Formulation with BiocidalTest Results

A-6 % B-6 % C-6 % D-6 % E-6 % F-6 % G-6 % Ingredient (W/W) (W/W) (W/W)(W/W) (W/W) (W/W) (W/W) Sodium Phosphate, 0.165 0.165 0.165 0.165 0.1650.165 0.165 Heptahydrate, Dibasic Sodium Phosphate, 0.050 0.050 0.0500.050 0.050 0.050 0.050 Monohydrate, monobasic Sodium Chloride 0.6500.650 0.650 0.650 0.650 0.650 0.650 Potassium Chloride 0.250 0.250 0.2500.250 0.250 0.250 0.250 Tetronic 908 0.250 0.250 0.250 0.250 0.250 0.2500.250 Ammonium Chloride 0.20 0.20 0.20 0.20 0.20 — — Stabilized Chlorine0.01 0.01 0.01 0.01 0.01 — — Dioxide C12-C14- 0.0125 0.0075 0.00300.0010 0.0001 0.0075 0.0030 alkyl(ethylbenzyl)dimethylammonium chloride(80%) pH 7.0 7.0 7.0 7.0 7.0 7.0 7.0 Osmolarity 290 290 290 290 290 290290 Biocidal Test Results Staphylococcus NG NG NG NG NG NG NG aureusPseudomonas NG NG NG NG NG NG NG aeruginosa Candida albicans NG NG NG NGNG NG NG Fusarium solani NG NG NG NG Positive NG NG NG: no growthPositive: at least 1 colony forming unit (CFU) of growth.

Example 7: Exemplary Phosphate/Borate Buffer Based Formulation withBiocidal Test Results

A-7 % B-7 % C-7 % D-7 % E-7 % F-7 % G-7 % H-7 % (W/W) (W/W) (W/W) (W/W)(W/W) (W/W) (W/W) (W/W) Buffer Borate Phosphate Stabilized 0.005% 0.005%0.005% 0.005% Chlorine Dioxide to to 1.0% to to 1.0% 1.0% 1.0% ammonium0.001% 0.001% 0.001% 0.001% chloride to to 2.0% to to 2.0% 2.0% 2.0%C12-14- 0.00005% 0.00005% 0.00005% 0.00005%alkyl(ethylbenzyl)dimethylammonium to to to to chloride (80%) 0.1% 0.1%0.1% 0.1% Biocidal Test Results P. aeruginosa NG Positive Positive NG NGPositive Positive NG S. aureus NG Positive Positive NG NG PositivePositive NG C. albicans Positive Positive NG NG Positive Positive NG NGF. solani Positive Positive NG NG Positive Positive NG NG NG: no growthPositive: at least 1 colony forming unit (CFU) of growth.

Individual ingredient formulations (A-7 to C-7 and E-7 to G-7) andcombinatory components formulation (D-7 and H-7) were tested forantimicrobial activity using standard procedural methodology(International Standards Organization). Minimum inhibitoryconcentrations (MICs) were defined as the lowest concentration ofantimicrobial that will inhibit the visible growth of a micro-organismafter incubation. MICs are used by diagnostic laboratories and as aresearch tool to determine the in vitro activity of new antimicrobials.In this particular set of MIC assays, either one or more of the activecomponents of the novel formulation were added (100 μl) to an innoculum(10 ml) of a Gm+(Staphylococcus aureus), Gm− (Pseudomonas aeruginosa),or fungi (Candida albicans, Fusarium albicans) each at an approximateconcentration of 1.0E+04-1.0E+06 CFU/ml. After a 24 hour contact time, asample of each test tube was plated on media specific to each bacteriaor fungi, and growth was recorded. Growth of more than one colony on anyof the agar plates was considered a failure (positive) of one or more ofthe components of the novel formulation to kill the microbial innoculumat that selected concentration of the component and/or mixture thereof.MIC testing usually were initiated with higher concentrations of thecomponents and then halted once, by virtue of dilution, the MIC isachieved for each component and/or mixtures thereof.

In the present testing, three active components, stabilized chlorinedioxide, ammonium chloride, and C12-14-alkyl(ethylbenzyl)dimethylammonium chloride were provided either singularly or within amixture in either a phosphate or borate buffering system. The bufferingagents are considered inactive ingredients and provide pH adjustment andtonicity requirements for use in human health care applications and haveno purported antimicrobial activity.

Example 8: Formulation is Effective in Killing Infectious ProtozoaAcanthamoeba Spp.

Free living amebae of the genus Acanthamoeba are saprophytic protozoathat are ubiquitous in the environment. Particular species of the genus,including Acanthamoeba castellanii, can cause severe infections in man.One manifestation of A. castellanii infection includes extremely rareopportunistic granulatomas encephalitis that can develop only afteraccidental oral/nasal insufflation. A more common, albeit rare, diseasesyndrome includes Acanthamoeba keratitis resulting from inadvertentocular exposure to environmental sources. The latter condition isconsidered a severe form of keratitis that can lead to long termsequelae including blindness if left untreated. A significant increaseof diagnosed cases of Acanthamoeba keratitis, particularly among contactlens users, has been observed over the last decade.

There are few options for treatment of Acanthamoeba keratitis.Conventional chemotherapeutic agents, including antibiotics andantifungals have no efficacy against this agent. Biocidal agents,including povidone-iodine, polyhexamethylene biguanide (Baquacil),hexamidine, and chlorhexidine, collectively have shown marginal efficacybut are also cytotoxic to the cornea and surrounding tissue.

The anti-protozoal efficacy of a formulation disclosed herein, e.g.,STR-325 (comprising stabilized chlorine dioxide, ammonium chloride andC12-14-alkyl(ethylbenzyl) dimethylammonium chloride) against A.castellanii trophozoites in an experimental colorimetric assay (McBride,J, Ingram, P R, Henriquez, F L, Roberts, C W. J Clin Microb, February;43(2):629-34, 2005) was tested. The efficacy against two leadingover-the-counter multipurpose solutions (MPS) as comparators wasevaluated. The assay in this study used cultured A. castellaniitrophozoites originating from corneal scrapings and was obtained fromATCC (Manassas, Va.). A. castellanii was propagated using specificliquid media (PYG w/inhibitory antibiotics) under sterile conditions.Trophozoites were enumerated using a Coulter cell counter and verifiedby light microscopy and a hemocytometer. Alamar blue was used as avitality dye, and effectively measures cellular respiration. Theintensity of the dye degraded at an equivalent rate of remaining activetrophozoites in solution; thus the reciprocal of the measured absorbanceof the dye was correlative to the remaining active trophozoites in thetest well. Predetermined concentrations of active trophozoites (1.2E+3cells/well) were used for the assay, and exactly 25 μl of eitherSTR-325, dilutions thereof, or comparator MPS were aliquoted into A.castellanii-loaded wells; testing was performed in sextuplicate (6wells/solution). Disinfectant-A. castellanii solutions were incubatedfor either 96 or 1 hour and then read on a spectrophometer at 570 nm.

Results of the testing are shown in FIG. 14A and FIG. 14B. STR-325 wasefficacious in killing all trophozoites at both incubation times, andmaintained effectiveness even when serially diluted (1:10). Bothcomparator solutions (ReNu, Biotrue) had marginal effects on reductionof active trophozoites at 96 hr incubation, and no effect at the shorter(1 hr) incubation time.

Example 9: Exemplary Formulation and Compounding Procedure

The compounding tank was charged with USP water (80% total finalvolume). The following ingredients were then added: sodium phosphate,monohydrate, monobasic, sodium phosphate, heptahydrate, dibasic, sodiumchloride, and potassium chloride. The mixture was stirred for NLT (Notless than) 15 minutes. Tetronic® 908 was slowly added into thecompounding tank and mixed until dissolved completed (NLT 30 minutes).The mixture was cooled below 45 C and the following ingredients wereadded: ammonium chloride, stabilized chlorine dioxide, andC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride. The resultingmixture was mixed for NLT 30 minutes. The pH and osmolarity weremeasured (Targeted pH=7.0, and Osmolarity 300). Sterility: use 0.22 μmsterilizing filter (Minipore).

1. A medical disinfecting composition comprising: (a) a chlorite salt;(b) a quaternary ammonium salt, wherein the quaternary ammonium salt isC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride; (c) ammoniumchloride having a formula of NH₄Cl; and (d) water.
 2. The medicaldisinfecting composition of claim 1, wherein the chlorite salt is analkali metal chlorite salt.
 3. The medical disinfecting composition ofclaim 2, wherein the alkali metal chlorite salt is sodium chlorite. 4.The medical disinfecting composition of claim 3, wherein the sodiumchlorite is present in an amount ranging from about 0.0001% to about0.1% (w/w).
 5. The medical disinfecting composition of claim 3, whereinthe sodium chlorite is provided as a stabilized chlorine dioxidesolution.
 6. The medical disinfecting composition of claim 5, whereinthe stabilized chlorine dioxide is present in an amount ranging fromabout 0.005% to about 1.0% (w/w).
 7. The medical disinfectingcomposition of claim 5, wherein the stabilized chlorine dioxide solutioncomprises chlorine dioxide.
 8. (canceled)
 9. (canceled)
 10. (canceled)11. The medical disinfecting composition of claim 1, wherein theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.00005% to about 0.1% (w/w).
 12. The medicaldisinfecting composition of claim 11, wherein theC12-C14-alkyl(ethylbenzyl)dimethylammonium chloride is present in anamount ranging from about 0.001% to about 0.1% (w/w).
 13. The medicaldisinfecting composition of claim 1, wherein the ammonium chloride ispresent in an amount ranging from about 0.001% to about 2.0% (w/w). 14.The medical disinfecting composition of claim 1, further comprising abuffer to maintain the pH between about 7 and about
 8. 15. The medicaldisinfecting composition of claim 14, wherein the pH is about
 7. 16.-30.(canceled)